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Individual

DR. DONALD AUGUST PELSOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 W WENGER RD, ENGLEWOOD, OH 45322
(937) 836-9921
(937) 836-1298
Mailing address
120 W WENGER RD, ENGLEWOOD, OH 45322
(937) 836-9921
(937) 836-1298

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102335 IN
IN
208000000X
Pediatrics Physician
Primary
35 04 3249P
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000011347
ANTHEM BCBS
OH
05
0410531
OH
01
1220023
UNITED HEALTH CARE
OH
05
2080948
OH
01
D43249
HUMANA
01
NO9285501
GROUP MEDICARE
Enumeration date
01/17/2006
Last updated
11/26/2013
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